Proactive Physical Therapy LLC.

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

PROACTIVE PHYSICAL THERAPY LLC.

Practice address

701 Anthony St
Port Gibson, MS 39150-2053

Phone

(601) 218-5004

NPI assigned

Mar 17, 2025

Last updated

Jan 5, 2026By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Kendrique Akeem Morgan, DPTNPI 1548993074

Title

Owner

Phone

(601) 218-5004

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kendrique Morgan, DPT

  • Physical Therapist
  • Port Gibson, MS
  • NPI 1548993074
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1742169600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1767571200000",
    "number": "1538969795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 ANTHONY ST",
            "city": "PORT GIBSON",
            "state": "MS",
            "postal_code": "391502053",
            "telephone_number": "601-994-3548",
            "fax_number": "601-448-0234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 ANTHONY ST",
            "city": "PORT GIBSON",
            "state": "MS",
            "postal_code": "391502053",
            "telephone_number": "601-218-5004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROACTIVE PHYSICAL THERAPY LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-17",
        "last_updated": "2026-01-05",
        "certification_date": "2026-01-05",
        "status": "A",
        "authorized_official_last_name": "MORGAN",
        "authorized_official_first_name": "KENDRIQUE",
        "authorized_official_middle_name": "AKEEM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "601-218-5004",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Saketa McEntee Polk, PMHNP-BC
• Polks Crossgates Discount Drugs Inc (polks specialty homecare)
• Quality Rehab, Inc
• Renex Dialysis Facilities, Inc. (Fresenius Medical Care Port Gibson)
• Michael T. Robinson
• Lindsey Rushing
• Sav Rite Discount Drugs Inc

• Physical Therapist in Port Gibson, MS
• Providers in Port Gibson, MS by specialty
• Physical Therapist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.